States ramp up exchange enrollment efforts amid limited resources, funding

With less than 75 days till open enrollment begins for health insurance exchanges, time is running out for education, outreach and enrollment efforts. But states are hitting the ground running, according to a panel discussion at the World Congress 4th Annual Leadership Summit on Health Insurance Exchanges in Washington, D.C., on Wednesday.

In fact, 18 states have released request for proposals (RFP) related to consumer assistance and nine have awarded navigator or in-person assistor (IPA) grants so far. And some states already have started training navigators and IPAs, as well as certified application counselors (CACs) and community organizations to help consumers apply for and enroll in coverage through the online marketplaces, the panel noted.

But much work remains: Information from Enroll America shows four out of five likely customers have no idea exchanges exist, noted panelist Brian Gorman, director of outreach and consumer education at Illinois Health Insurance Marketplace.

His state, which has a state-federal partnership exchange, is raising the level of consumer awareness with help from an RFP for a market vendor.

Awareness is not enough, however; selling coverage through the exchanges also requires a whole new level of interaction, Gorman said. To move from awareness to enrollment, Illinois has dedicated $28 million in grants for assistance programs.

The matter becomes more challenging for states that lack the capacity for the necessary consumer assistance.

With no time to create capacity, Illinois is making the most of existing community-based organizations, such as housing, food services, any trusted entity in Illinois, and encouraging them to apply for education/outreach and enrollment assistance efforts. "We don't have the resources to do all the things we want to do so we need to leverage what is there," Gorman said.

Some states may find themselves more resource-strapped than others when it comes to educating and enrolling consumers. That's because the different types of exchanges have different consumer assistance funding options, panelist Jennifer Sullivan, director of Best Practices Institute at Enroll America.

For example, Vermont and its state-based exchange will have funding for a navigator and IPA program, and community health center grants that comes to about $86 per uninsured person to help connect consumers to coverage.

Arkansas, a partnership state, will have navigator and IPA program funding and community health center grants that equal about $73 per uninsured person. Meanwhile, IPA program funding won't be available in Florida, a state that defaulted to a federally-facilitated exchange (FFE). It will only have navigator funding and community health center grants for about $4 per uninsured person to help connect the uninsured to coverage, Sullivan noted.

For FFE states that won't have a lot of funded assistance available, certified application counselors are crucial to increased exchange enrollment. CACs can serve in a volunteer capacity or through third-party sources, such as hospitals. "They're the last best hope for making sure people have the help they need," Sullivan said.

Regardless of available funding, the panelists said states should recognize there is a role for everyone in consumer education and outreach, payers, hospitals and brokers.

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